NPIMap

Organization Active NPI

Providence Health & Services - Washington

  • Case Manager/Care Coordinator
  • Spokane, WA
National Provider Identifier
1003006008
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
H139 Issued in WA
Legal business name
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Practice address
5633 N Lidgerwood St
Spokane, WA 99208-1224
Phone
(509) 482-0111
Fax
(509) 482-2456
NPI assigned
Jul 26, 2007
Organization subpart
Yes
Parent organization
PROVIDENCE HEALTH & SERVICES - WASHINGTONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Donald Wayne Anderson Jr.
Title
Assistant Secreatry for Enrollment
Phone
(425) 358-9786

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193400000X SINGLE SPECIALTY GROUP 171M00000X H139 WA Primary
General Acute Care Hospital 282N00000X H 139 WA

Addresses

Primary practice location

5633 N Lidgerwood St
Spokane, WA 99208-1224

Mailing address

910 N Washington St
Suite 209
Spokane, WA 99201-2260
Phone (509) 232-1173

Other names 1

  • HOLY FAMILY MATERNITY SUPPORT SERVICES Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Providence Health Serv-Wa3 organizations share this tax ID, including this one
Part of
Providence Health Services - Washington

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746576000000",
    "number": "1003006008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 N WASHINGTON ST",
            "address_2": "SUITE 209",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012260",
            "telephone_number": "509-232-1173",
            "fax_number": "509-232-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5633 N LIDGERWOOD ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992081224",
            "telephone_number": "509-482-0111",
            "fax_number": "509-482-2456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES - WASHINGTON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDENCE HEALTH & SERVICES - WASHINGTON",
        "enumeration_date": "2007-07-26",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "ASSISTANT SECREATRY FOR ENROLLMENT",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "WA",
            "license": "H139",
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "WA",
            "license": "H 139",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOLY FAMILY MATERNITY SUPPORT SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.